Friday, April 6, 2012

Which came first? The chicken or the egg? {and Happy 18 Month Birthday Claire!}

Today is Claire's 18 month birthday!  It's so hard to think that she is already a year and a half old!  We are so proud of her in all that she has accomplished and all that she will do in her lifetime. 

On a good note, Claire seems to be feeling better today.  She was awake a few times last night but not as bad as the night before.  I was anxious to get the lab results today and was sure she had rotavirus.  But when I got a call from the pediatrican today she said she had talked to the hospital and they all labs came back negative. So we had no idea what caused Claire to be so sick.  

I had pretty much just accepted that it was some sort of virus, but spent a lot of time today comparing Claire's metabolic panel/liver panel labs as they were high this week.  I am still not done investigating this and want to know what is causing her BUN, AST, and ALT and a few other things to be so high.  The sickness?  The dehydration?  Or is something going on with her liver?

About 2 hours later, my phone rang again and it was the pediatrician again. She was not happy.  She said that the ER doctor had called her back and said that Claire's urine culture had tested positive for Klebiella Oxtoca and that she also had a UTI.  She was upset that the doctor had told her the wrong information earlier.  The pediatrician went back to her office to find my number to call me.  It was plain as day in Claire's chart from the ER visit, but the pediatrician told me they did not have those records in her chart in the office yet.  So I am not sure where the miscommunication came into play but that is not good and she was not happy. 

She hung up with me to call the infectious disease doctor at ECU to see what they recommended.  That doctor said they usually don't treat infections with 30,000 organisms, but given Claire's medical history, that ID doctor recommended we treat Claire with antibiotics.  So then the pediatrician called Duke to try to talk to Dr. Martin (Claire's liver doctor) about her liver panels and everything, but she was not in.  She talked to Dr. Rice, another pediatric surgeon, but he couldn't give her any liver answers. 

So the pediatrician did her research and found that this KO is resistant to most antibiotics.  And the majority of the ones that it is not resistant to cannot be taken by patients with liver issues.  So she finally found one Claire could take and discussed it with her pharmacist to be sure.  I really appreciate and like that this doctor did so much research for Claire.  This is a different doctor than we normally see but she is  really great and on top of things it seems!

Basically, this KO can cause the UTI and can also cause the diarrhea like Claire had.  It can also cause sepsis and other infections.  It usually happens in preemies that are in the NICU, patients in the hospital, or older patients in nursing homes.  So we are not sure why Claire got it.  And it made me think back to the time she had these same symptoms at Duke and they thought she had c. diff but it ended up being a UTI.  I am going to research and see if she also had KO......  Anyways, since everyone has KO in their bodies, I don't know how it all started.  Hence which came first, the KO or the UTI? 

No wonder she is miserable - UTI, ear infection, GI infection, diarrhea, vomiting, dehydration....

Here is a link to read more about Klebsiella Oxytoca:

Please continue to keep Claire in your prayers. 

1 comment:

  1. 18 months?! big girl! And poor poor little girl, praying for her!!!